FMGE 2017 Previous Year Questions Practice Questions

Q: Cords of Billroth in spleen are found in

Red pulp. ***Correct: Red pulp*** - The **cords of Billroth** (or splenic cords) are a distinctive histological feature of the **red pulp** of the spleen. - These cords consist of a meshwork of reticular cells and reticular fibers, packed with macrophages, lymphocytes, plasma cells, and abundant red blood cells. *Incorrect: White pulp* - The **white pulp** is primarily involved in immune functions, containing lymphoid follicles rich in lymphocytes. - It is organized around central arterioles and does not contain the cords of Billroth. *Incorrect: Trabecular zone* - The **trabecular zone** consists of connective tissue septa that extend inward from the splenic capsule, carrying blood vessels and nerves. - It provides structural support to the spleen but is not where the cords of Billroth are located. *Incorrect: Mantle zone* - The **mantle zone** is a region within the **white pulp**, surrounding the germinal centers of lymphoid follicles. - It is composed mainly of naive B lymphocytes and is distinct from the cords of Billroth. [Practice more FMGE 2017 questions on OnCourse]

Q: NOT a content of carpal tunnel:-

Ulnar nerve. ***Ulnar nerve*** - The **ulnar nerve** passes superficial to the **flexor retinaculum**, meaning it is not a direct content of the carpal tunnel [1]. - Instead, it travels through a separate space known as **Guyon's canal**, alongside the ulnar artery [1]. *Median nerve* - The **median nerve** is a primary content of the carpal tunnel and is susceptible to compression within this space, leading to carpal tunnel syndrome [1]. - It provides sensory innervation to the lateral palm and digits, and motor innervation to certain thenar muscles [1]. *Flexor digitorum profundus* - The tendons of the **flexor digitorum profundus** muscles (four of them) pass through the carpal tunnel to insert onto the distal phalanges. - These tendons are responsible for **flexion of the distal interphalangeal (DIP) joints** of the medial four fingers. *Flexor digitorum superficialis* - The tendons of the **flexor digitorum superficialis** muscles (four of them) also pass through the carpal tunnel. - They are responsible for **flexion of the proximal interphalangeal (PIP) joints** of the medial four fingers. [Practice more FMGE 2017 questions on OnCourse]

Q: Heberden's arthropathy affects:

Distal interphalangeal joint. ***Distal interphalangeal joint*** - **Heberden's nodes** are pathognomonic bony enlargements that occur on the **distal interphalangeal (DIP) joints** of the fingers [1]. - They are a classic sign of **osteoarthritis**, resulting from cartilage degeneration and new bone formation [1]. *Lumbar spine involvement* - While osteoarthritis can affect the **lumbar spine**, it presents as **back pain** and stiffness, not as nodules on the fingers [1]. - **Heberden's nodes** are specifically associated with peripheral joint involvement, not axial skeleton [1]. *Sacroiliac joint involvement* - **Sacroiliac joint involvement** is characteristic of **spondyloarthropathies** like ankylosing spondylitis, causing inflammatory back pain [1]. - It does not present with bony nodes on the fingers, which are typical of osteoarthritic changes [1]. *Knee joint involvement* - **Knee joint involvement** is common in osteoarthritis, causing pain, swelling, and reduced range of motion [1]. - However, **Heberden's nodes** are distinct from knee symptoms and refer specifically to changes in the DIP joints [1]. [Practice more FMGE 2017 questions on OnCourse]

Q: Which of the following is not associated with pulmonary arterial hypertension?

Left ventricular hypertrophy. ***Left ventricular hypertrophy*** - **Left ventricular hypertrophy** is typically caused by conditions that increase the workload on the left ventricle, such as **systemic hypertension** or **aortic stenosis** [1]. - Pulmonary arterial hypertension directly affects the **pulmonary vasculature**, leading to increased pressure in the pulmonary circuit and ultimately right heart strain, not left ventricular hypertrophy. *Cor pulmonale* - **Cor pulmonale** is defined as **right ventricular enlargement** secondary to lung disease or pulmonary vascular disease. - Pulmonary arterial hypertension increases the afterload on the right ventricle, causing it to dilate and hypertrophy, eventually leading to **right heart failure** (cor pulmonale) [2]. *Mitral Stenosis* - **Mitral stenosis** causes an obstruction to blood flow from the left atrium to the left ventricle, leading to increased pressure in the left atrium and pulmonary veins. - This elevated pressure can be transmitted backward into the pulmonary arteries, leading to **pulmonary arterial hypertension** [3]. *Interstitial lung disease* - **Interstitial lung disease** (ILD) can lead to destruction and remodeling of the pulmonary capillaries, increasing pulmonary vascular resistance [2]. - This increased resistance causes the pulmonary arterial pressure to rise, resulting in **pulmonary arterial hypertension**. [Practice more FMGE 2017 questions on OnCourse]

Q: Which of these is least effective as first-line treatment for dangerous hyperkalemia?

Intravenous sodium bicarbonate. ***Intravenous sodium bicarbonate*** - While it can drive potassium into cells, its effect is often **delayed and unreliable** in acute, dangerous hyperkalemia, especially without concurrent acidosis. - Its efficacy is most pronounced when hyperkalemia is associated with **metabolic acidosis**, which is not always the primary driving factor of dangerous hyperkalemia. *Calcium chloride injection* - This is a **first-line treatment** for dangerous hyperkalemia, as it **stabilizes the cardiac membrane** by antagonizing the direct effects of potassium on myocardial excitability [1]. - It does not lower serum potassium levels but **protects the heart** from life-threatening arrhythmias, buying time for other therapies to reduce potassium [1]. *Beta-2 agonist (Salbutamol)* - **Beta-2 agonists** like salbutamol are effective in shifting potassium **intracellularly**, thereby lowering serum potassium levels. - This effect is mediated by stimulating the **Na+/K+-ATPase pump** on cell membranes. *Dialysis (Hemodialysis)* - **Hemodialysis** is the **most effective and rapid** method for removing excess potassium from the body, especially in cases of severe or refractory hyperkalemia. - It provides definitive treatment by directly **filtering potassium** from the blood, and is often considered when other measures fail or in patients with kidney failure. [Practice more FMGE 2017 questions on OnCourse]

Question 1

Cords of Billroth in spleen are found in

Accepted Answer

Red pulp

Answer

White pulp

Answer

Trabecular zone

Answer

Mantle zone

Question 2

NOT a content of carpal tunnel:-

Accepted Answer

Ulnar nerve

Answer

Median nerve

Answer

Flexor digitorum profundus

Answer

Flexor digitorum superficialis

Question 3

Heberden's arthropathy affects:

Accepted Answer

Distal interphalangeal joint

Answer

Lumbar spine involvement

Answer

Sacroiliac joint involvement

Answer

Knee joint involvement

Question 4

Which of the following is not associated with pulmonary arterial hypertension?

Accepted Answer

Left ventricular hypertrophy

Answer

Cor - pulmonale

Answer

Mitral Stenosis

Answer

Interstitial lung disease

Question 5

Which of these is least effective as first-line treatment for dangerous hyperkalemia?

Accepted Answer

Intravenous sodium bicarbonate

Answer

Calcium chloride injection

Answer

Beta-2 agonist (Salbutamol)

Answer

Dialysis (Hemodialysis)

Question 6

Lauge - Hansen classification belongs to:-

Accepted Answer

Ankle fracture

Answer

Femur fracture

Answer

Shoulder fracture

Answer

Elbow fracture

Question 7

Meningococcal meningitis is seen with which of the following complement deficiency?

Accepted Answer

C5

Answer

C4

Answer

C1q

Answer

C2

Question 8

A 6 year old child who does not interact with other children of his age group and prefers playing alone with repetitive behaviors, is likely to be suffering from:

Accepted Answer

Autism

Answer

ADHD

Answer

Depression

Answer

Bipolar disorder

Question 9

Which of the following is the best management for radiation induced occlusive disease of carotid artery?

Accepted Answer

Carotid angioplasty and stenting

Answer

Carotid endarterectomy

Answer

Low dose aspirin

Answer

Carotid bypass procedure

Question 10

A 50 kg patient has 40 % burn of the body surface area. Calculate the ringer lactate solution to be given for first 8 hours of fluid:

Accepted Answer

4 Litres

Answer

8 Litres

Answer

2 Litres

Answer

1 Litre

FMGE 2017

Anatomy

Internal Medicine

Orthopaedics

Pathology

Psychiatry

Surgery